BACKGROUND: Limited data are available regarding the serum lipids in primary sclerosing cholangitis.
AIMS: To determine the lipid levels in patients with primary sclerosing cholangitis.
METHODS: We monitored the serum lipid levels annually for up to 6 years in 157 patients included in three previous trials of ursodeoxycholic acid.
RESULTS: The baseline lipid values were: total cholesterol=207 mg/dL (127-433); high-density lipoprotein=56 mg/dL (26-132); low-density lipoprotein=129 mg/dL (48-334); triglycerides=102 mg/dL (41-698). Cirrhotic stage was associated with lower levels of total cholesterol (186 mg/dL vs. 217 mg/dL, p=.02). A significant correlation between the liver biochemistries and total and low-density lipoprotein cholesterol levels was observed. Ursodeoxycholic acid, as compared to placebo, significantly decreased total (-27 mg/dL vs. 22 mg/dL, p=.0004) and low-density lipoprotein cholesterol (-24 mg/dL vs. 17 mg/dL, p=.0001). After extended follow-up, small changes in the lipid levels were noticed. The incidence of coronary artery disease was 4%.
CONCLUSIONS: Our findings suggest that the lipid levels in primary sclerosing cholangitis are often above levels where treatment with lipid-lowering agents is recommended. However, primary sclerosing cholangitis patients seem to have no elevated risk for cardiovascular events. The correlation of total and low-density lipoprotein cholesterol with liver biochemistries implies that mechanisms linked to cholestasis may regulate cholesterol metabolism.